<include file="$head"/>
<script>$(document).ready(function() {
$('.ui-title').text('用户充值');//标题
});
</script>
<div data-role="content">
<form name=alipayment action="<if condition="C('AP_TYPE') eq 1">./Trade/ap_jishi/alipayapi.php<else/>./Trade/ap_danbao/alipayapi.php</if>" method="post" data-ajax="false">
<p>您的余额：
                        <font color=red>{$row[money]}</font>
                        <span>元</span>
</p>
            
<input  name="WIDtotal_fee" placeholder="充值金额 单位（元*）" />
              <input  name="WIDsubject" value="{$config.sitetitle}会员在线充值" placeholder="充值名称(*）" />

                      <input size="30" name="WIDbody" placeholder="备注" />
                        
                       <input size="30" name="WIDreceive_mobile" placeholder="联系电话"/>
                        
					<span style="display:none;">
					<dt>商户订单号：</dt>
                    <dd>
                        <span class="null-star">*</span>
                        <input size="30" name="WIDout_trade_no" value="CZ{:time()}-{$_SESSION[dami_uid]}" />
                        <span>商户网站订单系统中唯一订单号，必填
</span>
                    </dd>
					
                    <dt>商品展示地址：</dt>
                    <dd>
                        <span class="null-star">*</span>
                        <input size="30" name="WIDshow_url" value="http://www.damicms.com/Case" />
                        <span>需以http://开头的完整路径，如：http://www.xxx.com/myorder.html
</span>
                    </dd>
                    <dt>收货人姓名：</dt>
                    <dd>
                        <span class="null-star">*</span>
                        <input size="30" name="WIDreceive_name" /> <input size="30" name="WIDseller_email" value="{:C('AP_EMAIL')}" />
                        <span>如：张三
</span>
                    </dd>
                    <dt>收货人地址：</dt>
                    <dd>
                        <span class="null-star">*</span>
                        <input size="30" name="WIDreceive_address" />
                        <span>如：XX省XXX市XXX区XXX路XXX小区XXX栋XXX单元XXX号
</span>
                    </dd>
                    <dt>收货人邮编：</dt>
                    <dd>
                        <span class="null-star">*</span>
                        <input size="30" name="WIDreceive_zip" />
                        <span>如：123456
</span>
                    </dd>
                    <dt>收货人电话号码：</dt>
                    <dd>
                        <span class="null-star">*</span>
                        <input size="30" name="WIDreceive_phone" />
                        <span>如：0571-88158090
</span>
                    </dd>
					</span>
                    
                        <button class="new-btn-login" type="submit" style="text-align:center;" data-theme="e">立即充值</button>
                      
</form>
</div>
</div>